High cholesterol is a common condition that affects millions of people. Cholesterol levels tend to rise as we get older, and high cholesterol is a major risk factor for heart disease. This leads many people to wonder – does high cholesterol ever go away on its own, or is it a lifelong condition that requires ongoing management?
What Causes High Cholesterol?
Cholesterol is a waxy, fat-like substance that is found in all of the cells in your body. Your body needs cholesterol to build healthy cells, but problems arise when you have too much of it in your blood. When there is excess cholesterol in your bloodstream, it can start to build up on the walls of your arteries, forming plaques that make your arteries narrow and less flexible. This buildup is known as atherosclerosis, and it increases your risk for heart attack and stroke.
There are two main causes of high cholesterol:
- Diet – Eating foods that are high in saturated and trans fats can raise your cholesterol levels. Foods that commonly contribute to high cholesterol include fatty meats, full-fat dairy products, fried foods, baked goods, and tropical oils like coconut and palm oils.
- Genetics – Some people inherit genes from their parents that make them predisposed to higher cholesterol levels. Familial hypercholesterolemia is an inherited form of high cholesterol that typically leads to very high LDL levels.
Other potential contributors include being overweight or obese, getting older, diabetes, kidney disease, pregnancy, and certain medications.
Cholesterol Levels
When you get your cholesterol tested, you will receive a breakdown of your cholesterol levels:
- Total cholesterol – This is the total amount of cholesterol in your blood from LDL, HDL, and other particles. A level below 200 mg/dL is considered desirable for most adults.
- LDL (bad) cholesterol – LDL particles deposit cholesterol into your artery walls, contributing to plaque buildup. LDL levels below 100 mg/dL are optimal.
- HDL (good) cholesterol – HDL particles remove excess cholesterol from your bloodstream and arteries. Higher levels above 60 mg/dL are considered protective.
- Triglycerides – Triglycerides are a type of fat in your blood that your body uses for energy. Levels below 150 mg/dL are considered normal.
Your doctor will look at all of these markers together to determine your risk for cardiovascular disease. Having optimal levels can help lower your risk.
Does High Cholesterol Ever Go Away on Its Own?
For most people, high cholesterol does not resolve on its own without treatment and lifestyle changes. There are a few exceptions where cholesterol levels may improve without intervention:
- Weight loss – Losing excess body weight can help improve cholesterol levels, especially triglycerides and HDL. However, significant weight loss is often needed for major improvements.
- Diet changes – If you cut back on saturated fats, trans fats, and cholesterol in your diet, your cholesterol may decrease slightly. But dietary changes alone are rarely enough to bring down high LDL cholesterol into the optimal range.
- Reducing alcohol – Heavy alcohol consumption can raise triglycerides. If you significantly reduce your drinking, triglyceride levels may drop.
- Stopping smoking – Quitting smoking can increase HDL cholesterol while lowering LDL levels. But LDL levels often remain elevated without other interventions.
Perhaps most importantly, as you get older your cholesterol levels tend to progressively worsen. Without proactive treatment, most people with high cholesterol will continue to have high cholesterol indefinitely.
How is High Cholesterol Treated?
The main treatment options for lowering cholesterol include:
- Statins – Statins are cholesterol-lowering medications that work by reducing the production of cholesterol in your liver. They are very effective at lowering LDL levels and are usually the first-line medication treatment.
- Other prescription medications – Other options like ezetimibe (Zetia), PCSK9 inhibitors, niacin, fibrates, and bile acid resins may be added if statins are not enough.
- Supplements – Some supplements like fish oil, soy protein, fiber, and plant sterols/stanols can provide a modest cholesterol benefit.
- Lifestyle changes – A heart-healthy diet low in saturated fat and cholesterol along with regular exercise are recommended to support lowering cholesterol levels.
For people with very high cholesterol or established heart disease, LDL cholesterol targets are typically set below 70 mg/dL or lower. This often requires a combination of statins with other medications and lifestyle changes.
What Happens When You Stop Taking Cholesterol Medication?
If you stop taking cholesterol-lowering medications like statins, your cholesterol levels will almost always rise back up over time. Some key points about stopping cholesterol medication:
- LDL cholesterol levels will start to climb within 4-6 weeks of stopping medication.
- Total cholesterol can increase by an average of around 37 mg/dL after stopping statins.
- The higher your cholesterol is to begin with, the more it will rebound after stopping treatment.
- Any heart disease risk reduction from treating high cholesterol will start to diminish after stopping medication.
For these reasons, cholesterol medication is intended to be taken long-term. Your doctor will monitor your cholesterol to determine if drug therapy should be adjusted or continued. Sudden discontinuation is not recommended without first consulting your healthcare provider.
Can You Permanently Lower Cholesterol?
While in most cases high cholesterol does not resolve permanently on its own, taking proactive steps can help lower your cholesterol levels and keep them under control in the long-term. The key is consistency both with treatment and lifestyle changes.
Here are some tips for lowering cholesterol permanently:
- Take cholesterol medication as directed. Statins are safe for lifelong use for most people.
- Maintain a diet low in saturated fat, trans fat, and cholesterol. Avoid fatty or processed meats and fried foods. Eat plenty of fruits, vegetables, whole grains, beans, fish and healthy fats like olive oil.
- Exercise regularly with both cardio and strength training. Exercise boosts HDL and helps manage weight.
- Reach or maintain a healthy body weight. Losing extra pounds can improve cholesterol numbers.
- Limit alcohol to moderate intake only. Heavy drinking negatively impacts cholesterol.
- Quit smoking and avoid exposure secondhand smoke. Smoking damages arteries and worsens cholesterol.
Implementing healthy habits and following your doctor’s medication and testing recommendations provides the best chance at controlling high cholesterol over the long-term.
When to See Your Doctor
If you have high cholesterol, follow up regularly with your primary care physician and discuss treatment options. You should also see your doctor promptly if you experience:
- New signs of heart disease – Chest pain, shortness of breath, heart palpitations
- Side effects of cholesterol medication – Persistent muscle aches or weakness
- Sudden change in health status – Significant weight change, loss of appetite, fatigue
Monitoring your health and being attentive to changes allows your doctor to provide the best ongoing care for managing high cholesterol.
Conclusion
High cholesterol is a common and treatable condition. However, it typically does not go away permanently on its own without proactive treatment and lifestyle changes. Medications combined with heart-healthy habits provide the best results for lowering cholesterol long-term. Working closely with your doctor is important, as high cholesterol requires ongoing management. But by taking control of your health, you can keep cholesterol levels in check and minimize the risk of heart disease.